MEDICARE: DR. DAVID RUSSELL CLEMONS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	30534	TX
2	103TF0000X	Family Psychologist	30534	TX
3	103TC1900X	Counseling Psychologist	30534	TX
4	103TA0400X	Addiction (Substance Use Disorder) Psychologist	30534	TX

General Provider Information

NPI Number	:	1841207404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RUSSELL CLEMONS PSY.D.

Provider Business Mailing Address
First Line	:	4131 SPICEWOOD SPRINGS RD STE E1
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8658
Country	:	US
Telephone Number	:	512-825-3283
Fax Number	:	512-640-4337

Provider Business Practice Location Address
First Line	:	4131 SPICEWOOD SPRINGS RD STE E1
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8658
Country	:	US
Telephone Number	:	512-825-3283
Fax Number	:	512-640-4337

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	10/07/2025

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